Adolescent Barbell Coaching – PAR-Q, Safety & Consent Form

Adolescent Barbell Coaching – PAR-

First Name

Last Name

Date of Birth

Age

Parent / Guardian Name

Emergency Contact Number

Relationship To Participant

To be completed by parent/guardian for ages 12–15; self-completed or co-signed for ages 16–17

Heart condition, fainting episodes, or need supervised activity?

Chest pain, dizziness, or unusual breathlessness during exercise?

High blood pressure, heart murmur, or cardiovascular issue?

Previous injury affecting barbell training?

Current medical treatment or monitoring?

Medications affecting exercise tolerance or heart rate?

Recent surgery or advised to avoid strenuous activity?

Asthma, breathing issues, allergies, inhaler/EpiPen?

Learning, behavioural, or neurological conditions (ADHD, ASD, anxiety)?

Concerns: coordination, confidence, growth, or past gym experiences?

Comfortable training in a public gym environment?

Additional Coaching, Learning & Safety Information

Students will be learning new movement patterns, often for the first time. They may use muscles and patterns unfamiliar to them, sometimes under load, within a short coaching window. Public gyms can also be loud or distracting. For safety and correct learning: – The coach may need to stand in close proximity. – Physical cueing may be required to correct technique or ensure proper muscle activation. – This prevents unsafe mimicry and reduces injury risk.

Most hands-on guidance occurs only in the first few sessions.
After foundational patterns are learned, students typically require minimal assistance.

Parent/Guardian Consent

I confirm that the information provided is accurate and give permission for my child to participate in barbell and strength training sessions with GetRed Studios. I understand the environment, the learning demands, and the possible need for safe physical cueing.

I agree to follow coaching instructions, train safely, communicate discomfort, and respect the training environment.

Todays Date

By submitting this form, you agree that GetRed Studios may contact you regarding your enquiry and process your information in accordance with our Privacy Policy.

Name

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Do you feel pain in your chest when you do physical activity?

In the past month, have you had chest pain when you were not doing physical activity?

Do you lose your balance because of dizziness or do you ever lose consciousness?

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart conditions?

Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?

Do you know of any other reason why you should not do physical activity?

1. Explanation of the exercise test - you will perform a number of exercise tests. The exercise intensity of each will be at a level appropriate to your ability. I may stop the test at any time because of signs of fatigue or, you may stop when you wish because of personal feelings of fatigue or discomfort.

2. Risks and discomforts - there exists the possibility of certain changes occurring during the test. They include abnormal blood pressure, fainting, disorder of heartbeat and in rare instances, heart attack, stroke or death. Every effort will be made to minimise these risks by evaluation of preliminary information relating to your health and fitness and by observations during testing. Trained personnel are available to deal with unusual situations that may arise.

3. Responsibilities of the client -information you possess about your health status or previous experiences of unusual feelings with physical effort may affect the safety and value of your exercise tests. Prompt reporting of feelings of effort during the exercise tests are of great importance. It is your responsibility to fully disclose such information when requested.

4. Benefits to be expected- the results obtained from the exercise tests will assist in evaluating what type of physical activities you may participate in.

5. Injuries - any questions about the procedures used in the exercise tests are encouraged. If you have any doubts or questions, please ask for further explanations.

6. Freedom of consent - your permission to perform the exercise tests is voluntary. You are free to deny consent or stop at any point, if you so desire.

I have read this form and I understand the test procedures that I will perform. I consent to participate.

Adolescent Barbell Coaching – PAR-Q, Safety & Consent Form

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